Tex. HHSC Medicaid Hospice Provider Manual § 5240

Revision 05-1; Effective December 2, 2005

General inpatient care is paid for each day an individual on Medicaid hospice elects to receive care through a Medicaid hospice provider. Rates are paid for general inpatient care in approved inpatient facilities. An approved inpatient facility is a Medicaid hospice provider that meets the conditions of participation for providing direct inpatient care, a hospital or an NF that meets the standards regarding 24-hour nursing services and patient areas. Individuals may receive pain control, or acute or chronic symptom management that cannot be managed in other settings. Services must conform to a written plan of care.

HHSC pays the Medicaid hospice inpatient care rate for the date of admission and all subsequent inpatient days. HHSC does not pay the general inpatient care rate for day of discharge; however, HHSC will pay the general inpatient care rate for day of death. General inpatient care days are subject to the limitation on total hospice inpatient care days.